Spotted!

(: (: very excited! my photos have been spotted by an online gallery that wants to help me put them up for (proper) sale! Despite everything, deep down, I've always really wanted to be an artist. Last chance to buy my work on the cheap!

Punchbag

It will be one of those patients who has had an unusual presentation of a rare disease, with symptoms mimicking something more common and invariably more benign. And now they've developed diarrhoea, or bleeding from some orifice, and we need to take some blood for further tests. "No, you are NOT taking any more blood from my baby," the mother fairly shouts at me. She stands up - her arms planted on her hips, her face stony, eyes burning. It is Sunday, and she vents her frustration at the events of the past week. She feels the doctors are hiding something from her, and keep changing their minds. She demands that I somehow produce the results of all the tests done on Friday afternoon (most of them are microbiology specimens, which will take at least 5 days to return final results). Having seen her child for the first time 5 minutes ago, I am at a loss as to what to say. My task is to take the blood. I have 10 other patients to get through before lunchtime. I decide to do the 'see things from the other person's point of view' thing. I let her go on for a bit. "I can see why you're frustrated," I say, at last. "K* is clearly very ill, and we don't have a certain diagnosis." I am just about to artfully explain the delays and justify the need for further tests (clotting, electrolytes as she is on IV fluid, and stool culture), when she interrupts and lets forth another torrent. Why, if we think K* has an infection, is she not on antibiotics? Why do the doctors tell her one thing and then contradict it? I begin to explain that the commonest cause of infective diarrhoea in children is a viral infection, and that antibiotics do not help a viral infection. "Why didn't they grow the poo for viruses then?" At this point I am exasperated, and return, rather too bluntly, that we have treated her child to the best of our knowledge and that the results of today's tests will help take things forward. In order to escape from the room, I say I will give her some time to think over things and come back later. She shouts after me that no-one is going to take any samples from her child and that's final. In retrospect, I guess she wasn't really interested in the logic behind the decisions, she just wanted someone to shout at, and it happened to be me. I hate my job.

What I saw on call today

...busy but unusually interesting day at work. Too tired to write proper entry, so here's a list of things I saw:
-CSF leak in child with base of skull fracture
-cri-du-chat syndrome
-VACTERL
-paracetamol overdose
-pneumonia
-two PUOs (pyrexia of unknown origin)
-newly diagnosed diabetic - the 7th of 10 children - and her pregnant mom (large orthodox Jewish family)
-lots of babies with bronchiolitis, and
-Dr. X, self-titled 'architect' of the BREATHE trial

Weekend misery
Still not impressed by the fact that the first train into central London tomorrow is at 08:38 when I need to be at work by 08:30. So I have to get up extra early for an extra long commute by BUS just to get to work on a SUNDAY. I miss my bike...

Still on study leave

I miss work (though will probably regret saying this when I am on call at the weekend). The exam is on the 17th of January but I've had to take my study leave now as I will be working lots of nights just before. Am sitting in the flat without any curtains in the windows at the moment as the workmen came round to put the double glazing in today. It's noticeably warmer already. I've also done all my christmas shopping in the last 2 hours without leaving the house (or, indeed, my seat). So its been a productive yet incredibly boring day. Read the Economist over lunch too, as M has a subscription. I like how it's written. Perhaps it is my profound lack of knowledge of economics that makes the magazine so fascinating, but I just get the feeling the BMJ is a whole lot less intelligent.

Lullaby

...just recalling the last time I was taking blood from a 1 year-old. Her (young, very bling) mother was singing to her to try and calm her down. The song of choice? Don't cha by the Pussycat Dolls.